Hyperaldosteronism

Artificial intelligence could aid in early detection of psychological distress among hospital workers, according to research conducted by New York University's Grossman School of Medicine. WHY IT MATTERS The study, led by researchers at NYU Langone Health, demonstrates how AI was able to detect signs of mental stress among healthcare professionals. The research could hold significant promise for the future of AI-based mental health screening efforts. The research, published this week in the Journal of Medical Internet Research AI , delved into virtual psychotherapy transcripts involving more than 800 healthcare professionals, including physicians, nurses, and emergency medical staff. Transcripts from 820 individuals who received psychotherapy during the initial wave of COVID-19 in the United States, but were not part of the healthcare workforce, were included for comparison. The findings, published online in the Journal of Medical Internet Research AI, revealed that among healthcare workers, those who discussed topics such as their experiences in hospital units, sleep deprivation, or mood issues during therapy sessions were more likely to receive diagnoses of anxiety and depression. The study identified four distinct conversation themes related to healthcare workers, including virus-related fears and experiences on hospital floors and ICU units. While the heightened risk for anxiety and depression in healthcare workers discussing their experiences was relatively small at 3.6%, the model is expected to improve its distress identification capabilities as more data becomes available. According to study lead author Matteo Malgaroli, a research assistant professor in the Department of Psychiatry at NYU Langone Health, this represents a significant advancement in mental health screening for healthcare professionals. THE LARGER TREND The use of AI could potentially play a role for a broader population, emphasizing the efficacy of AI technology to aid in mental health support, with natural language processing potentially evolving into a screening tool for detecting and tracking anxiety and depression symptoms. Burnout is growing among physician assistants and those in the medical profession more generally as they battle growing data volumes and a contracting workforce. According to a recent national survey of nurses, 100,000 nurses quit their jobs during the pandemic, and by 2027, nearly 900,000, or almost one-fifth of the 4.5 million registered nurses nationwide, plan to do the same, endangering the overall national healthcare system if no action is taken. In addition to using AI to spot stress symptoms, the technology could also be leveraged to identify clinical workflow flaws and create a strategy for improvements. Doximity's AI-powered chatbot tool , for example, could reduce the time doctors spend on administrative burdens. In July 2022, a health technology project in Hong Kong received $5 million in public funding to introduce an AI-based data-driven approach to mental health diagnosis and treatment. Changi General Hospital has already leveraged AI to spot curable hypertension , with its hypertension-focused lab with Shimadzu reducing the turnaround time of testing for primary aldosteronism, which was previously done overseas. Talkspace uses linguistic regression to analyze de-identified behavioral health messages and alert providers to patients at risk for self-harm , illustrating the potential for AI to detect additional mental health issues on the patient side. ON THE RECORD "Our findings show that those working on the hospital floor during the most intense moment of the pandemic faced unique challenges on top of their regular job-related stressors which put them at high risk for serious mental health concerns," said Malgaroli in a statement. "These results suggest that natural language processing may one day become an effective screening tool for detecting and tracking anxiety and depression symptoms, added study senior author psychiatrist Naomi Simon, MD, a professor in the Department of Psychiatry at NYU Langone. Nathan Eddy is a healthcare and technology freelancer based in Berlin. Email the writer: nathaneddy@gmail.com

The Changi General Hospital has made testing for curable forms of hypertension more accessible and quicker for Singaporeans by leveraging the latest analytical techniques. Its clinical laboratory with Japanese medical equipment manufacturer Shimadzu, Shimadzu-CGH Clinomics Centre (SC3), has recently started offering tests for identifying primary aldosteronism and salt-sensitive hypertension which are based on liquid chromatography with tandem mass spectrometry and AI. According to a press statement, this combination of analytical techniques offers higher analytical specificity and sensitivity and the capability to precisely measure hormone levels (particularly aldosterone and renin) in a patient’s blood sample. WHY IT MATTERS High blood pressure or hypertension, which is a primary cause of heart disease and stroke, affects one in three adults in Singapore, according to the Ministry of Health's latest population health survey. About 5% of them have the most common yet least known curable form of hypertension called primary aldosteronism. Despite the higher prevalence, many patients with this condition are not screened or treated, CGH notes. Moreover, about nine in ten Singaporeans are now consuming more salt than recommended in their diets, which increases the risk of developing hypertension among persons who are salt-sensitive. Identification therefore is key to starting treating, and eventually arresting the rise in cases of, such curable forms of hypertension, CGH stressed. Before the establishment of SC3 in 2021, testing for curable hypertension was done abroad, "which often took several weeks for results to be ready," CGH said. With clinical tests for primary aldosteronism now available at SC3, turnaround time has been shortened to three to five days, allowing more patients to be quickly screened for and cured of treatable forms of hypertension. Since launching the service in February this year, over 1,000 clinical tests have been conducted at SC3. Dr Daryl Hee, CGH senior manager and head of the SC3, disclosed their plan to secure more partnerships with public and private hospitals around Singapore to reach the wider population. In addition, the SC3, which serves as a regional reference centre, is also developing mass spectrometry solutions for diagnosing other chronic conditions in other Asia-Pacific countries . THE LARGER TREND Hypertension remains a largely incurable condition. However, treatments exist for managing blood pressure. Digital therapeutics is one treatment innovation that has come out in recent years. One player in this space, the Japanese company CureApp, has developed a hypertension DTx which has been found effective in reducing the risks of cardiovascular and cerebrovascular diseases in users. In May last year, the said app was given regulatory approval from the Japanese government , which was said to be the world's first for a hypertension DTx. ON THE RECORD "Some of my patients have lived with hypertension for many years before eventually undergoing aldosterone and renin testing and being diagnosed with primary aldosteronism. With access to these clinical tests at the SC3 in Singapore, doctors can now obtain accurate and prompt test results for our patients," said Troy Puar, clinical assistant professor and senior consultant of the Department of Endocrinology at CGH. "Hopefully, this will result in more patients being screened and treated for this curable form of hypertension," A/Prof Puar, who is also the principal investigator at SC3, added. Khoo Keow Pin, 66, is one of the patients that got recently treated for curable hypertension. For the past 15 years, he lived with hypertension without knowing that what he had was the primary aldosteronism type. He first received his consultation at CGH in June and later received his official diagnosis for the condition following testing at SC3. Last month, he underwent an adrenalectomy surgery to get his affected adrenal gland removed. For the first time after several years, his blood pressure became normal and stabilised. "With the quick and detailed investigations done at SC3, the doctors were able to arrive at the accurate diagnosis of my type of hypertension – primary aldosteronism – enabling me to seek treatment at CGH and improve my condition," Khoo said.

New study reveals drivers of rare cancer and provides a possible alternative solution to surgery. The genetic code of a rare form of kidney cancer, called reninoma, has been studied for the first time. In the new paper, published today (25th September) in Nature Communications, researchers at the Wellcome Sanger Institute, Great Ormond Street Hospital and The Royal Free Hospital also revealed a new drug target that could serve as an alternative treatment if surgery is not recommended. There are around 100 cases of reninoma reported to date worldwide (1), and it is amongst the rarest of tumours in humans. Although it can usually be cured with surgery, it can cause severe hypertension or it can spread and develop into metastases. There are no existing medical treatments for reninoma and management involves surgery alone. Until now, it had been unknown what genetic error causes reninoma. In the new study, a collaboration between the Wellcome Sanger Institute and Great Ormond Street Hospital and The Royal Free Hospital, funded by The Little Princess Trust, researchers found that there is a specific error in the genetic code of a known cancer gene, NOTCH1, that is behind the development of this rare cancer. The team examined two cancer samples -- from a young adult and a child (2) -- with advanced genomic techniques, known as whole genome and single nuclear sequencing (3). Their findings suggest that the use of existing drugs targeting this specific gene is a possible solution to treating reninoma for patients where surgery is not a viable option. Taryn Treger, first author of the study and The Little Princess Trust Fellow at the Wellcome Sanger Institute, said: "Many cancerous tumours have already been deciphered with genomic technologies, however, this is not so true in rare cancers, particularly those affecting children. Our work aims to fill that gap. This is the first time that we have identified the drivers for reninoma and we hope that our work continues to pave the way towards new therapies for childhood cancers." Dr Tanzina Chowdhury, co-lead author of the study, at Great Ormond Street Hospital, said: "Rare kidney cancers known as reninomas do not respond to conventional anti-cancer therapies. The only known treatment at the moment is surgery. Our study shows that, actually, there is a specific and well-studied gene that drives this rare cancer. If we use already known drugs that affect this gene, we might be able to treat it without the need for an invasive technique such as surgery." Dr Sam Behjati, co-lead author of the study, Wellcome Senior Research Fellow at the Wellcome Sanger Institute and Honorary Consultant Paediatric Oncologist at Addenbrooke's Hospital, said: "Rare cancers are exceedingly challenging to study, and patients with such tumours may therefore not benefit from cancer research. Here, we have a powerful example of cutting-edge science rewriting our understanding of an ultra rare tumour type, reninoma, whilst delivering a finding that potentially has immediate clinical benefits for patients." Phil Brace, Chief Executive of The Little Princess Trust, said: "We are committed to funding research searching for more effective treatments for all childhood cancers and so we are delighted to hear of the discoveries that have been made. We also want to help researchers find kinder solutions for young people and so we are very pleased to hear there may be ways to treat this rare kidney cancer without the need for surgery." Notes: 1. Inam, R., Gandhi, J., Joshi, G., Smith, N. L. & Khan, S. A. Juxtaglomerular Cell Tumor: Reviewing a Cryptic Cause of Surgically Correctable Hypertension. Curr. Urol. 13, 7-12 (2019). 2. The samples came from a young child with a localised tumour from the UMBRELLA study and a young female adult with metastatic (lung) reninoma. 3. Whole genome sequencing is a method that analyses the entire genome of an organism. Single nucleus sequencing is a method that uses isolated nuclei -- the part of the cell that contains our DNA information -- instead of whole cells to understand genes and their functions.